1. Nthawi ya Prothrombin (PT):

PT imatanthauza nthawi yofunikira kuti prothrombin isinthe kukhala thrombin, zomwe zimapangitsa kuti plasma coagulation igwire ntchito, zomwe zimasonyeza ntchito ya coagulation ya extrinsic coagulation pathway. PT imadziwika makamaka ndi kuchuluka kwa coagulation factors I, II, V, VII, ndi X zomwe zimapangidwa ndi chiwindi. Coagulation factor yofunika kwambiri mu extrinsic coagulation pathway ndi factor VII, yomwe imapanga FVIIa-TF complex yokhala ndi tissue factor (TF). , yomwe imayambitsa extrinsic coagulation process. PT ya amayi apakati abwinobwino imakhala yochepa kuposa ya amayi omwe si apakati. Pamene factors X, V, II kapena I ichepa, PT imatha kutalikitsidwa. PT siikhudzidwa ndi kusowa kwa coagulation factor imodzi. PT imatalikitsidwa kwambiri pamene kuchuluka kwa prothrombin kumatsika pansi pa 20% ya mulingo wabwinobwino ndipo factors V, VII, ndi X zimatsika pansi pa 35% ya mulingo wabwinobwino. PT imatalikitsidwa kwambiri popanda kuyambitsa kutuluka magazi kosazolowereka. Kufupikitsidwa kwa nthawi ya prothrombin panthawi ya mimba kumawonedwa mu matenda a thromboembolic ndi hypercoagulable states. Ngati PT ndi yayitali kwa masekondi atatu kuposa momwe munthu amaonera, matenda a DIC ayenera kuganiziridwa.

2. Nthawi ya Thrombin:

Nthawi ya Thrombin ndi nthawi yosinthira fibrinogen kukhala fibrin, yomwe ingawonetse mtundu ndi kuchuluka kwa fibrinogen m'magazi. Nthawi ya Thrombin imafupikitsidwa mwa amayi oyembekezera abwinobwino poyerekeza ndi amayi omwe si apakati. Panalibe kusintha kwakukulu mu nthawi ya thrombin panthawi yonse ya mimba. Nthawi ya Thrombin ndi gawo lofunikira kwambiri la zinthu zowononga fibrin ndi kusintha kwa dongosolo la fibrinolytic. Ngakhale nthawi ya thrombin imafupikitsidwa panthawi ya mimba, kusintha pakati pa nthawi zosiyanasiyana za mimba sikofunikira, zomwe zikuwonetsanso kuti kuyambika kwa dongosolo la fibrinolytic mu mimba yabwinobwino kumakulitsidwa. , kuti kulinganize ndikuwonjezera ntchito yolimbitsa thupi. Wang Li et al[6] adachita kafukufuku woyerekeza pakati pa amayi oyembekezera abwinobwino ndi amayi omwe si apakati. Zotsatira za mayeso a thrombin nthawi ya gulu la amayi oyembekezera ochedwa zinali zazifupi kwambiri kuposa za gulu lolamulira ndi magulu oyambira ndi apakati a mimba, zomwe zikusonyeza kuti index ya nthawi ya thrombin mu gulu la amayi oyembekezera otsiriza inali yayikulu kuposa ya PT ndi thromboplastin yoyambitsidwa. Nthawi (nthawi yogwira ntchito ya thromboplastin, APTT) imakhala yovuta kwambiri.

3. APTT:

Nthawi ya thromboplastin yogwiritsidwa ntchito pang'ono imagwiritsidwa ntchito kwambiri kuzindikira kusintha kwa ntchito yotsekeka kwa njira yotsekeka kwa mkati. Pansi pa mikhalidwe ya thupi, zinthu zazikulu zotsekeka zomwe zimakhudzidwa ndi njira yotsekeka kwa mkati ndi XI, XII, VIII ndi VI, zomwe coagulation factor XII ndi chinthu chofunikira kwambiri panjirayi. XI ndi XII, prokallikrein ndi high molecular weight excitogen zimagwirira ntchito limodzi mu gawo lolumikizana la coagulation. Pambuyo poyambitsa gawo lolumikizana, XI ndi XII zimayambitsidwa motsatizana, motero zimayamba njira yotsekeka kwa mkati. Malipoti a mabuku akuwonetsa kuti poyerekeza ndi amayi omwe si apakati, nthawi yotsekeka kwa gawo la thromboplastin mu mimba yachibadwa imafupikitsidwa panthawi yonse ya mimba, ndipo trimester yachiwiri ndi yachitatu ndi yochepa kwambiri kuposa yomwe ili pachiyambi. Ngakhale kuti pa mimba yachibadwa, coagulation factors XII, VIII, X, ndi XI imawonjezeka mofanana ndi kuwonjezeka kwa masabata a mimba panthawi yonse ya mimba, chifukwa coagulation factor XI singasinthe mu trimester yachiwiri ndi yachitatu ya mimba, ntchito yonse ya endogen coagulation Pakati pa mimba ndi kumapeto, kusintha sikunali koonekeratu.

4. Fibrinogen (Fg):

Monga glycoprotein, imapanga peptide A ndi peptide B pansi pa thrombin hydrolysis, ndipo pamapeto pake imapanga fibrin yosasungunuka kuti iletse kutuluka magazi. Fg imagwira ntchito yofunika kwambiri pakusonkhanitsa ma platelet. Ma platelet akayatsidwa, fibrinogen receptor GP Ib/IIIa imapangidwa pa nembanemba, ndipo ma platelet aggregates amapangidwa kudzera mu kulumikizana kwa Fg, ndipo pamapeto pake thrombus imapangidwa. Kuphatikiza apo, monga puloteni yogwira ntchito mwachangu, kuwonjezeka kwa kuchuluka kwa Fg m'magazi kumasonyeza kuti pali kutupa m'mitsempha yamagazi, komwe kungakhudze rheology yamagazi ndipo ndiye chinthu chachikulu chomwe chimayambitsa kukhuthala kwa plasma. Imagwira ntchito mwachindunji pakukhuthala ndikuwonjezera kukhuthala kwa ma platelet. Pamene preeclampsia ichitika, kuchuluka kwa Fg kumawonjezeka kwambiri, ndipo ntchito yolimbitsa thupi ikachepa, kuchuluka kwa Fg pamapeto pake kumachepa. Kafukufuku wambiri wobwerezabwereza wasonyeza kuti kuchuluka kwa Fg panthawi yolowa m'chipinda choberekera ndiye chizindikiro chofunikira kwambiri cholosera kuchitika kwa kutuluka magazi pambuyo pobereka. Mtengo wabwino wolosera ndi 100% [7]. Mu trimester yachitatu, plasma Fg nthawi zambiri imakhala 3 mpaka 6 g/L. Panthawi yoyambitsa kutsekeka kwa magazi, kuchuluka kwa magazi Fg m'magazi kumateteza kuchepa kwa magazi m'thupi. Pokhapokha ngati plasma Fg>1.5 g/L ingatsimikizire kuti magazi akuyenda bwino, pamene plasma Fg <1.5 g/L, ndipo pazochitika zoopsa Fg <1 g/L, chisamaliro chiyenera kuperekedwa ku chiopsezo cha DIC, ndipo kuwunikanso kuyenera kuchitika. Poyang'ana kwambiri kusintha kwa Fg mbali zonse ziwiri, kuchuluka kwa magazi Fg kumakhudzana ndi ntchito ya thrombin ndipo kumachita gawo lofunika kwambiri pakusonkhanitsa ma platelet. Pazochitika zomwe Fg imakwezedwa, chisamaliro chiyenera kuperekedwa pofufuza zizindikiro zokhudzana ndi kutsekeka kwa magazi ndi ma antibodies a autoimmune [8]. Gao Xiaoli ndi Niu Xiumin [9] adayerekeza kuchuluka kwa magazi Fg m'magazi mwa amayi apakati omwe ali ndi matenda a shuga a m'mimba komanso amayi apakati omwe ali ndi pakati, ndipo adapeza kuti kuchuluka kwa magazi Fg kunali kogwirizana ndi ntchito ya thrombin. Pali chizolowezi cha thrombosis.